Culture, bacterial
Facility: Golden Valley Memorial Hospital
Billing Code: 87070 (CPT)
- CPT Billing Code: 87070
- Insurance Median: $9
- Cash Discount Price: $60
- vs. Medicare Baseline: 1.04x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $8.62 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $9 | 104% |
| Home State Health | $9 | 104% |
| Humana | $9 | 104% |
| UnitedHealthcare | $9 - $15 | 104% |
| Ambetter / Centene | $10 | 116% |
Consumer Guidance & Cost Commentary
For this procedure at Golden Valley Memorial Hospital in Clinton, MO, the cash median rate is $60. This cash price is significantly lower than the facility's gross charge of $100 and represents a substantial discount compared to the commercial negotiated rates of $9 to $15 that insurers like Aetna, Humana, and UnitedHealthcare pay for the same service. While the facility's facility rating is 3 out of 5, the cash option remains the most accessible pricing tier available, particularly for patients with high-deductible plans where the insurance negotiated rate may exceed the cash price.
Patients should be aware that prompt-pay discounts, typically ranging from 20% to 50%, can further reduce the $60 cash median if paid in full upfront within a brief window, bypassing the administrative overhead of insurance claims processing. Although the Medicare amount for this service is $8.62, which serves as a benchmark for true cost, commercial rates often include administrative loadings that inflate the baseline price. To ensure you are not subject to balance billing or unexpected charges, it is crucial to request a self-pay classification and a full itemized audit before scheduling, as over 80% of hospital bills contain errors that can be corrected through written dispute.